COMPREHENSIVE HESI REVIEW EXIT
EXAM QUESTIONS AND
ANSWERS(VERIFIED
ANSWERS)2025/2026
Acute Respiratory Distress Syndrome (ARDS) - CORRECT ANSWER -The exchange of oxygen for
carbon dioxide in the lungs is inadequate for oxygen consumption and carbon dioxide production
within the body's cells
Characteristics of ARDS - CORRECT ANSWER -Hypoxemia that persists even when 100% oxygen is
given; decreased pulmonary compliance; dyspnea; non-cardiac associated bilateral pulmonary
edema; dense pulmonary infiltrates on X-ray
ARDS - CORRECT ANSWER -No abnormal breath sounds are present in this disorder on
auscultation because the edema occurs first in the interstitial spaces and not the airways.
ARDS - CORRECT ANSWER -Unexpected, catastrophic pulmonary complication occurring in a
person with no pervious pulmonary problems.
ARDS - CORRECT ANSWER -Common laboratory finding is a lowered pO2; not responsive to high
concentrations of oxygen and often need intubation and mechanical ventilation with PEEP
PEEP Positive end-expiratory pressure - CORRECT ANSWER -The instillation and maintenance of
small amounts of air into the alveolar sacs to prevent then from collapsing each time the client
exhales; amount of pressure can be set and is usually around 5-10cm of water
Nursing Assessment of ARDS - CORRECT ANSWER -Dyspnea, hyperpnea; intercostals retractions;
cyanosis, pallor; hypoxemia; diffuse pulmonary infiltrates seen on chest radiograph as "white-out"
appearance; verbalized anxiety, restlessness
,Hypoxemia - CORRECT ANSWER -PO2 < 50mmHg with FiO2 >60%
Common causes of respiratory failure - CORRECT ANSWER -COPD; pneumonia; tuberculosis;
contusion; aspiration; inhaled toxins' emboli; drug OD; fluid overload; DIC; shock
Suction - CORRECT ANSWER -When providing care to a patient with ARDS, only do this when
secretions are present
7.35-7.45 - CORRECT ANSWER -PH normal value
35-45 mmH - CORRECT ANSWER -PCO2 normal value
22-26 mEq - CORRECT ANSWER -HCO3 normal value
80-100mm - CORRECT ANSWER -PO2 normal value
95-100% - CORRECT ANSWER -O2 normal value
Allen Test - CORRECT ANSWER -Perform this test before drawing an ABG from the radial artery
Common cause of respiratory failure in children - CORRECT ANSWER -Congenital heart disease;
respiratory distress syndrome; infection, sepsis; neuromuscular diseases; trauma and burns;
aspiration; fluid overload and dehydration; anesthesia and narcotic OD
Nursing assessment of child in respiratory failure - CORRECT ANSWER -Kid just "looks bad;" very
slow or very rapid RR, dyspnea, apnea, gasping; tachycardia; cyanosis, pallor, or mottled color;
irritability and lethargy; retractions, nasal flaring, poor air movement; hypoxemia, hypercapnia,
respiratory acidosis
Respiratory Failure - CORRECT ANSWER -PCO2 > 45 or PO2 < 60 on 50% O2; a child in severe
distress should be on 100% O2
,Shock - CORRECT ANSWER -Widespread, serious reduction of tissue perfusion which, if prolonged,
leads to generalized impairment of cellular functioning
System Hypotension - CORRECT ANSWER -Marked reduction in either cardiac output or peripheral
vasomotor tone, without a compensatory elevation in the other results in this
Early signs of shock - CORRECT ANSWER -Agitation and restlessness that results from cerebral
hypoxia
Hypovolemic Shock - CORRECT ANSWER -Related to external or internal blood or fluid loss
Cardiogenic Shock - CORRECT ANSWER -Related to ischemia or impairment in tissue perfusion
resulting from MI, serious arrhythmia, or HF; all cause decrease CO
Vasogenic Shock - CORRECT ANSWER -Related to allergens, spinal cord injury, or peripheral
neuropathies, all resulting in venous pooling and decreased blood return to the heart, which
decreases cardiac output over time
Septic Shock - CORRECT ANSWER -Related to endotoxins released by bacteria, which cause
vascular pooling, diminished venous return, and reduced CO
High fowler position with legs down - CORRECT ANSWER -Position to reduce venous return in
order to decrease further venous return to the left ventricle
Medical treatment for shock - CORRECT ANSWER -Rapid infusion of volume-expanding fluids such
as whole blood, plasma, plasma substitutes; isotonic, electrolyte IV solutions; CVP artery catheters;
CVP measurements, urine output, HR, clinical and mental state; immediate attendtion to
improvement of perfusion; administration of drugs is withheld until circulating volume has been
restores; O2 administration
Pulmonary edema - CORRECT ANSWER -If shock is cardiogenic in nature, the infusion of volume-
expanding fluids may result in this
Cardiac Function - CORRECT ANSWER -When treating a patient with shock, the restoration of what
should take priority
, Increase Cardiac Contractility - CORRECT ANSWER -Administration of cardiotonic drugs such as
digitalis does what?
Dopamine and digitalis - CORRECT ANSWER -Increases the contractility
Dopamine (Dopram) and norepinephrine (Levophed) - CORRECT ANSWER -Vaso-constricting
agents that may be used in cardiogenic shock
Nursing Assessment of patient in shock - CORRECT ANSWER -Tachycardia, tachypnea, decrease in
BP (systolic <80mmHg) ; mental status changes; cool, clammy skin; diaphoresis, paleness; urine
output decreases; CVP <4cm of H2O; urine SG >1.020
Hypovolemia - CORRECT ANSWER -Urine SG >1.020 indicates?
Early shock mental status changes - CORRECT ANSWER -Restless, hyper-alert
Late shock mental status changes - CORRECT ANSWER -Decreased alertness, lethargy, coma
Patient in shock - CORRECT ANSWER -Maintain a urine output of at least 30ml/hr and notify health
care provider if it drops below this
CVP - CORRECT ANSWER -Administer prescribed fluids until designated ?? is reached in patients
with shock
CVP - CORRECT ANSWER -When a patient is in shock, this number is usually elevated to 16-19 cm
of H2O as compensation for decreased cardiac output
Patient in shock - CORRECT ANSWER -Place this patient in Trendelenburg position (feet up 45
degrees, head flat
IM or Subcutaneous route - CORRECT ANSWER -Do not administer medications via these routes to
a patient in shock until perfusion improves to the muscles and subcutaneous tissues
EXAM QUESTIONS AND
ANSWERS(VERIFIED
ANSWERS)2025/2026
Acute Respiratory Distress Syndrome (ARDS) - CORRECT ANSWER -The exchange of oxygen for
carbon dioxide in the lungs is inadequate for oxygen consumption and carbon dioxide production
within the body's cells
Characteristics of ARDS - CORRECT ANSWER -Hypoxemia that persists even when 100% oxygen is
given; decreased pulmonary compliance; dyspnea; non-cardiac associated bilateral pulmonary
edema; dense pulmonary infiltrates on X-ray
ARDS - CORRECT ANSWER -No abnormal breath sounds are present in this disorder on
auscultation because the edema occurs first in the interstitial spaces and not the airways.
ARDS - CORRECT ANSWER -Unexpected, catastrophic pulmonary complication occurring in a
person with no pervious pulmonary problems.
ARDS - CORRECT ANSWER -Common laboratory finding is a lowered pO2; not responsive to high
concentrations of oxygen and often need intubation and mechanical ventilation with PEEP
PEEP Positive end-expiratory pressure - CORRECT ANSWER -The instillation and maintenance of
small amounts of air into the alveolar sacs to prevent then from collapsing each time the client
exhales; amount of pressure can be set and is usually around 5-10cm of water
Nursing Assessment of ARDS - CORRECT ANSWER -Dyspnea, hyperpnea; intercostals retractions;
cyanosis, pallor; hypoxemia; diffuse pulmonary infiltrates seen on chest radiograph as "white-out"
appearance; verbalized anxiety, restlessness
,Hypoxemia - CORRECT ANSWER -PO2 < 50mmHg with FiO2 >60%
Common causes of respiratory failure - CORRECT ANSWER -COPD; pneumonia; tuberculosis;
contusion; aspiration; inhaled toxins' emboli; drug OD; fluid overload; DIC; shock
Suction - CORRECT ANSWER -When providing care to a patient with ARDS, only do this when
secretions are present
7.35-7.45 - CORRECT ANSWER -PH normal value
35-45 mmH - CORRECT ANSWER -PCO2 normal value
22-26 mEq - CORRECT ANSWER -HCO3 normal value
80-100mm - CORRECT ANSWER -PO2 normal value
95-100% - CORRECT ANSWER -O2 normal value
Allen Test - CORRECT ANSWER -Perform this test before drawing an ABG from the radial artery
Common cause of respiratory failure in children - CORRECT ANSWER -Congenital heart disease;
respiratory distress syndrome; infection, sepsis; neuromuscular diseases; trauma and burns;
aspiration; fluid overload and dehydration; anesthesia and narcotic OD
Nursing assessment of child in respiratory failure - CORRECT ANSWER -Kid just "looks bad;" very
slow or very rapid RR, dyspnea, apnea, gasping; tachycardia; cyanosis, pallor, or mottled color;
irritability and lethargy; retractions, nasal flaring, poor air movement; hypoxemia, hypercapnia,
respiratory acidosis
Respiratory Failure - CORRECT ANSWER -PCO2 > 45 or PO2 < 60 on 50% O2; a child in severe
distress should be on 100% O2
,Shock - CORRECT ANSWER -Widespread, serious reduction of tissue perfusion which, if prolonged,
leads to generalized impairment of cellular functioning
System Hypotension - CORRECT ANSWER -Marked reduction in either cardiac output or peripheral
vasomotor tone, without a compensatory elevation in the other results in this
Early signs of shock - CORRECT ANSWER -Agitation and restlessness that results from cerebral
hypoxia
Hypovolemic Shock - CORRECT ANSWER -Related to external or internal blood or fluid loss
Cardiogenic Shock - CORRECT ANSWER -Related to ischemia or impairment in tissue perfusion
resulting from MI, serious arrhythmia, or HF; all cause decrease CO
Vasogenic Shock - CORRECT ANSWER -Related to allergens, spinal cord injury, or peripheral
neuropathies, all resulting in venous pooling and decreased blood return to the heart, which
decreases cardiac output over time
Septic Shock - CORRECT ANSWER -Related to endotoxins released by bacteria, which cause
vascular pooling, diminished venous return, and reduced CO
High fowler position with legs down - CORRECT ANSWER -Position to reduce venous return in
order to decrease further venous return to the left ventricle
Medical treatment for shock - CORRECT ANSWER -Rapid infusion of volume-expanding fluids such
as whole blood, plasma, plasma substitutes; isotonic, electrolyte IV solutions; CVP artery catheters;
CVP measurements, urine output, HR, clinical and mental state; immediate attendtion to
improvement of perfusion; administration of drugs is withheld until circulating volume has been
restores; O2 administration
Pulmonary edema - CORRECT ANSWER -If shock is cardiogenic in nature, the infusion of volume-
expanding fluids may result in this
Cardiac Function - CORRECT ANSWER -When treating a patient with shock, the restoration of what
should take priority
, Increase Cardiac Contractility - CORRECT ANSWER -Administration of cardiotonic drugs such as
digitalis does what?
Dopamine and digitalis - CORRECT ANSWER -Increases the contractility
Dopamine (Dopram) and norepinephrine (Levophed) - CORRECT ANSWER -Vaso-constricting
agents that may be used in cardiogenic shock
Nursing Assessment of patient in shock - CORRECT ANSWER -Tachycardia, tachypnea, decrease in
BP (systolic <80mmHg) ; mental status changes; cool, clammy skin; diaphoresis, paleness; urine
output decreases; CVP <4cm of H2O; urine SG >1.020
Hypovolemia - CORRECT ANSWER -Urine SG >1.020 indicates?
Early shock mental status changes - CORRECT ANSWER -Restless, hyper-alert
Late shock mental status changes - CORRECT ANSWER -Decreased alertness, lethargy, coma
Patient in shock - CORRECT ANSWER -Maintain a urine output of at least 30ml/hr and notify health
care provider if it drops below this
CVP - CORRECT ANSWER -Administer prescribed fluids until designated ?? is reached in patients
with shock
CVP - CORRECT ANSWER -When a patient is in shock, this number is usually elevated to 16-19 cm
of H2O as compensation for decreased cardiac output
Patient in shock - CORRECT ANSWER -Place this patient in Trendelenburg position (feet up 45
degrees, head flat
IM or Subcutaneous route - CORRECT ANSWER -Do not administer medications via these routes to
a patient in shock until perfusion improves to the muscles and subcutaneous tissues
